Semin Neurol 2020; 40(03): 277-285
DOI: 10.1055/s-0040-1708868
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Lifestyle Advice for Pediatric Migraine: Blaming the Patient, or Evidence Based?

Amy A. Gelfand
1   Department of Neurology, Child and Adolescent Headache Program, University of California, San Francisco, San Francisco, California
Samantha L. Irwin
1   Department of Neurology, Child and Adolescent Headache Program, University of California, San Francisco, San Francisco, California
› Author Affiliations
Further Information

Publication History

Publication Date:
15 April 2020 (online)


Children and teenagers with migraine are often advised to live a life of perfect balance—to sleep regularly and well, to eat breakfast each day, to drink plenty of water, and to exercise religiously. The logic is that doing so will decrease their migraine frequency. The corollary that follows is that failing to follow such advice will result in the patient continuing to experience migraine at its current frequency. This opens the door to potentially blaming the patients for their migraine and contributing to migraine stigma. This article reviews the current state of the evidence for each of these behavioral interventions for migraine prevention, and provides the clinician with practical advice for counseling patients.


A.A.G. has received consulting fees from Zosano, Eli Lilly, Impax, Theranica, and Impel Neuropharma. She has received honoraria from UpToDate (for authorship) and JAMA Neurology (as an associate editor). She receives grant support from Amgen. She receives personal compensation for medical–legal consulting. Her spouse received consulting fees from Biogen (daclizumab) and Alexion (eculizumab), research support from Genentech (Ocrevus), service contract support from MedDay, honoraria for editorial work from DynaMed Plus, and personal compensation for medical–legal consulting.

S.L.I. is the cofounder and CEO of a company named HeadSoothe Nutraceuticals Inc, which is working to develop a combination nutraceutical for the treatment of headache in children. This company is not associated with this work.

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